Endoscopic handling of post surgical female ureteral injuries

This study included 13 female patients with post-gynecologic [7] or post-obstetric ureteral [6] injuries. The diagnosis of ureteral injury was confirmed by clinical and radiological evaluation. Endoscopic correction was tried either by retrograde or antegrade approach. Ureteral injury was bilateral in four patients and unilateral in nine patients. Five patients presented in the same day of surgery, two of them were reoperated in the same day. Bilateral ureteral injury was corrected surgically in both of them. In the remaining three patients the general condition did not allow for reexploration. Retrograde pyelogram revealed hyper-angulation of the ureter in two and stenting was feasible in both of them. Complete ureteral obstruction was encountered in the third patient and PCN tube was placed. Eight patients presented few days after surgery. Retrograde pyelogram revealed complete obstruction in four patients, for whom PCN tube was placed as a temporary measure to save the renal units. Later on, antegrade studies were performed and surgical correction was done accordingly. In two patients the ureter was incompletely enclosed in sutures, those were handled ureteroscopically using the holmium YAG laser the sutures were fulgurated and the suture material was retrieved by three pronged grasper and stents were placed. In another patient with relative narrowing of the ureteral lumen balloon dilation and stent placement was done. In the last patient angulation was encountered and stent was successfully placed

Ultrastructural study of the periodontal ligament of dog's deciduous teeth after repeated injections by cadmium chloride

The effect of cadmium administration on the histogenesis of the periodontal ligament [PL] of dog deciduous teeth were studied by light and electron microscopic technique. Ten pregnant female dogs were divided into two groups, 5 animals for each. In group I, the dogs were injected with 0.5 mL of physiological saline and used as control. In the group II, the dogs were injected with cadmium chloride [l0mg/kg body weight] at three times intervals weekly. The periodontal ligament of deciduous anterior teeth of new born, at one month old age, were examined. According to our observations, the cadmium has harmful degenerative effect on periodontal ligament. Followed by regenerative response. The process was divided into two main stages. .1- During the first stage, prominent degenerative events took place in the periodontal ligament fibres. However, the blood vessels and nerves remained intact and were not affected. Phagocytosis and removal of necrotic material were well advanced and followed by marked regeneration of collagen fibres of periodontal ligament. 2- During the second stage, two populations of regenerating collagen fibres, based on the predominant cell type present, were observed in the tissue. One of apparently normal fibres located in areas where blood vessels and nerves were abundant and not affected. The other population of groups of regenerative fibres showing fibrotic tissue and collagen. This second type of fibres was predominant in areas where the number of blood vessels was greatly reduced and affected

Four-snip operation for involutional entropion

Objective is to evaluate an alternative surgical modality for the management of involutional lower lid entropion. The design is a prospective, interventional, non-comparative, case-series study. It included 15patients [30 eyes] having a lower lid involutional entropion. They were 10 males and 5 females [mean age = 55 years]. Four-snip procedure was done under local infiltrative anesthesia. Follow up ranged between 7 to 15 months [mean = 9 months].The procedure was successful in correcting entropion in all cases. There was one case of lid notching; but no recurrences. Four-snip procedure addresses the three underlying etiology of involutional entropion. It is remarkably successful in managing these cases with a pleasing cosmetic result and no major complications

Ureteroscopic manipulation in the re-implanted bilharzial ureter

Our purpose in this study is to evaluate the efficacy and safety of ureteroscopy in-patients with a re-implanted bilharzial ureter. The study included twenty-one patients with prior ureterovesical reimplantation because of bilharzial ureteral strictures. Seventeen patients had distal ureteral stones [2 multiple]. Four patients had retained foreign body in a re-implanted ureter; proximally migrated double-J stents in 3 and postoperative retained plastic catheter in one patient. Ureteroscopic manipulation was done for all patients using a small diameter ureteroscope 7.5 F. Preliminary cystoscopy revealed different locations for neo-ureteral orifices. Posteromedial in 13 patients, posterolateral in 2 patients and anterolateral in 6 patients. Stones were extracted in 15 patients [13 with single distal ureteral stones and 2 with multiple stones]. Stones were retrieved more easily in cases with posteromedially located orifices. Failure to negotiate the guide wire up the ureters was encountered in the 2 cases with posterolateral location of the orifices with termination of the procedure. Extraction of the proximally migrated stents and foreign body was successful in all the patients using a 3 pronged grasper. The location of the ureteral orifice influenced the success of the procedure. Reimplantation in the posteromedial location was the easiest to manipulate. Ureteroscopy has its role in patients with re-implanted bilharzial ureter. It can save the patient from a recurrent surgery with minimal or no complications. The site of the neo-ureteral orifices influence the success of the procedure

Neonatal diarrhoea in lambs and goat kids

Fecal samples from 200 untreated diarrheic lambs as well as 200 diarrheic goat kids, were screened for seven common enteropathogens, rotavirus, coronavirus, astrovirus, bredavirus, enterotoxigenic E. coli [ETE coli], Salmonella species and cryptosporidia causing diarrhea, in comparison with 100 apparently healthy animals of each species, of the same age on the same localities. The prevalence of infection was 94.5% and 46% in diarrheic lambs and goat kids, respectively. ETE coli, rotavirus, cryptosporidia and Salmonella species, respectively, showed significant association with diarrhea in lambs, while rotavirus, cryptosporidia and ETE coli, respectively, were recorded in goat kids. The highest incidence of ETE coli infection was observed during the first two weeks of life. On the other h and, Salmonella species could not be isolated before the 7th week. Rotavirus antigen was not detected in lambs or goat kids younger than one week of age, while its prevalence rate peaked at the 2nd and 3rd week of life. The peak of cryptosporidia infection was recorded between the 2nd and 4th of life

Ultrasonography for diagnosis of obstructive uropathy in children

This study included 34 children, 30 males and 4 females, their ages ranged from 3 months to 3 years. They were suffering from obstructive uropathy. After routine investigations, abdominal ultrasonography was done for them. They were divided into 3 groups according to their presentation and clinical examination, the first group [7 cases] was diagnosed by sonography as pelvic hydronephrosis, while plain X-ray and IVPs were not confirmative. The second group [12 patients] was diagnosed by ultrasonography as radiolucent stones in pelviureteric junctions or upper ureter that were unilateral in 3 cases and bilateral in 9 cases, while plain X-ray and IVU were not diagnostic. The third group [15 cases] was diagnosed by ultrasonography as infravesical obstruction and confirmed by cystourethrography and urethrocystoscopy. It could be concluded that ultrasonography is the best way for rapid and safe diagnosis of obstructive uropathy in infants and young children when compared to other methods of diagnosis

frequency of blood born viruses [HBV, HCV and HIV] among Egyptian thalassemic children

Repeated blood transfusions, splenectomy and iron overload increase the susceptibility of thalassemic patents to infection. This study was conducted in the Hematology Clinic of the New Children's Hospital, Cairo University. The study started in 1989 and extended over four years. It included 256 regularly transfused patients with thalassemia major, their age ranged from 2.5 to 14 years, 60 patients [21.74%] were splenectomized. The patients were evaluated in three consecutive serial groups. From the results obtained, it was clear that the frequency of exposure to HBV declined from 86.67% to 50.55%, while the HBsAg positivity decreased from 35% to 16.48% in the last four years. Out of the positive cases, 55.62% had a profile reflecting acquired immunity to HBV infection [HBcAb-IgG and HBsAb] and 13.75% were considered chronic asymptomatic carrier had either HBsAg alone or in association with HBcAb-IgG, they showed no clinical or laboratory evidences of acute hepatitis. Serological patterns of chronic HBV infection were detected in 23.75%, out of them 3.13% had HBeAg which reflect a state of active replication of the virus with high infectivity, while another 3.13% had HBeAb with low infectivity. Positive HCV antibodies were confirmed in 74.22% of the cases. Pathological changes of chronic specific hepatitis [active, persistant or lobular] were detected in 17/60 [28.33%] of the patients with +ve HBV and/or HCV markers. As regard AIDS immunological abnormalities including hypergammaglobulinemia and suppression of T cells and T helper cells were recorded. Although these abnormalities simulate some of the immunological abnormalities noted in AIDS related complex [ARC], these changes were recorded also in other different pediatric diseases. HIV antibodies were not recorded in the samples. Thalassemics are still prone to blood born viruses although to a lesser degree than before. The necessity of assessing viral status is vital to the clinician for improvement of the management of those patients

Urinary calculi in Minia governorate statistical study

The study included 3000 patients who attend the outpatient urology clinic and 500 patients who were admitted into urology department in one year duration from January 1990 to December 1990. Renal stones constitute 36.6 percent of all patients ham-urinary stones in the outpatient study and 27.3 percent in the inpatient study, the mean age of patients was 36.3 +/ -15.5 years, males constitute 81.3 percent and 63.3 percent of patients life in rural communities. The incidence of ureteric stones was 47.3 percent in the outpatient study and 38 4 percent in the admitted patients. The age incidence was 35.0 +/- 13.5 years; the male to female ratio was 5:1 in primary stone, 22:1 in stones formed above ureteric stricture. Stone bladder constitute 3.5 percent of hospital attendance, it affects male more than females. It constitutes 16.1 percent of all urinary tract stones. Age incidences is high from 1 to 5 years

Spongiosography: for diagnosis of urethral strictures

The available investigations of urethral strictures do not reveal the fibrosis and scarring of the corpus spongiosum. To obtain better information of fibrotic tissue damage in urethral strictures we had performed spongiosography, that is opacification of the spongy body by injection of contrast medium, in 23 patients in whom the diagnosis had already been established by uroflowmetry, urethrography and urethroscopy. Another 5 patients with erectile dysfunction were served as the control group. The investigation was well tolerated by all patients and no side effects or complications were encountered. Attenuation or even interruption of the contrast medium within the corpus spongiosum on spongiosography clearly revealed the fibrosis in urethral strictures. The extent of scarring was completely independent of the clinical symptoms and urethrographic findings. Accordingly, our decision on the appropriate surgical treatment was based mainly on the results of spongiosography. If used as an additional routine investigation in cases of urethral stricture spongiosography may help to decrease the recurrence rate in the future

Recurrent urinary tract infection in female patients

One hundred and fifty female patients suffering from recurrent urinary tract infection presented to El-Minia University Hospital in a period of 1.5 years were included in this study. All cases were randomly selected and divided into 6 groups; 42 pregnant, 24 pregnant diabetics, 56 middle aged, 18 diabetic middle aged, 10 unmarried females and 15 cases non - symptomatized were investigated as control. Mid-stream urine samples were taken from every patient and examined for biochemical reactions, microscopic examination, bacterial culture and sensitivity. We found significant bacteriaria in 42.7 percent of cases with bacterial count above 10[5] organisms per ml,., 52 percent of cases with bacterial count less than 10[5], while in 5.3 percent of cases the results of the cultures showed no growth although they were presented with urinary tract infection [U.T.I.]. Escherichia coli, staphylococcus aureus, streptococcus pyogenes and staphylococcus albus were the commonest organisms isolated from the diabetic pregnant females. While E. coli, Klebsiella, proteus and staphylococcus aureus were the commonest organisms isolated from the non - pregnant females. The most effective types of antibiotics used were Norfloxacin, Ofloxacin, Cefotaxim, and Cefoperazone. Short term therapy with these agents gave good results in uncomplicated upper U. T. I. with stones, abnormalities and other pathologies. Pseudomonas followed by E. Coli, staph. aureus and Klebsiella were the strongest [beta- lactamase producing organisms. Significant bacteriuria may be present in the absence of pyuria and vice versa

Endoscopic treatment of bilharzial bladder ulcer

Several methods of treatment have been tried for chronic bilharzial bladder ulcers. Endoscopic treatment of bilharzial bladder ulcers has been tried in this study, aiming for evaluation of its results as a line of treatment. Our study included 75 patients, 69 males and 6 females treated in Urology Department of El Minia University Hospital over two years duration, transuretheral resection was done for 45 patients, and transuretheral excision for 30 patients with no marked difference between the two techniques. However, transuretheral resection has the advantage in multiple ulcers. Follow up for those patients after treatment for 6 months revealed that 58 patients [77.3%] were symptoms free, 12 patients [16%] had slight burning micturition, and 5 patient [6.7%] had persistent symptoms. Cytoscopic examination was done 6 months after treatment revealed that recurrent ulceration still present in 5 patients [6.7%]. We concluded that endoscopic treatment of chronic bilharzial bladder ulcers is quite safe satisfactory manouver provided that the cases is accurately selected

Surgical management of female urinary fistulas

Our study included 32 female patients suffering from urinary fistula, were treated at El-Minia University Hospital in a period of 2.5 years. In 9 cases the fistulas were ureterovaginal and were treated transperitoneally by ureteroneocystostomy in 5 cases and Boari's flap in 4 cases with 100% success rate. In 22 patients with vesicovaginal fistulas, vaginal approach by flap splitting and vaginal flap techniques were applied for 8 cases with 50% success. The rest of the cases [14 plus the 4 cases of failed vaginal repair] were corrected successfully by the transabdominal approach using the bladder bisection technique with good dissection and separation of the bladder and vaginal wall and omental flap in complicated cases. One case of vesicouterine fistula also was treated in this study. All patients were continent postoperatively except 3 of them, were suffering from urge incontinence. We concluded that results of fistula repair depending mainly on surgeons clinical experience and individual technique

Antibodies to rinderpest virus in pig's sera

A total of 120 serum samples collected randomly from pigs were screened for the presence of neutralizing antibodies specific to rinderpest virus. The results revealed that 39.17% were positive. The data throw the light on the possible role played by pigs in the last epidemic of rinderpest in Egypt and draw attention to its future role in the control of the disease

Prevalence of hepatitis B virus markers in multitransfused infants

Four group including eighty multitransfused infants and children and fourteen age matched controls were enrolled in this study. The group of thalassaemia included 69 cases; the group of aplastic anaemia 6 cases and the group of other haematological disorders 5 cases. The hepatitis markers of "HBV" were done and the results were interpreted as profiles with combination of different serologic markers in patterns. This study highlights the undisputed value of hepatitis B vaccination to patients who receive regular transfusions of blood or blood products